Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06112 Halle, Saale, Germany.
Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany.
Patient Educ Couns. 2022 Apr;105(4):843-850. doi: 10.1016/j.pec.2021.07.017. Epub 2021 Jul 10.
To evaluate the relationship between participation in structured diabetes self-management education programs (DSME) and self-management behaviour (SMB) in routine care.
The study included 864 ever- and 515 never-DSME participants from the population-based survey German Health Update (GEDA) 2014/2015. SMB and clinical care variables were: Following a diet plan, keeping a diabetes diary, holding a diabetes pass, self-monitoring of blood glucose (SMBG), foot self-examination (FSE), retinopathy screening, haemoglobin A1c (HbA1c) measurement and examination of the feet by clinicians (FEC). We conducted logistic regression analyses for association of DSME-participation with SMB, adjusting for various variables.
DSME-participation was significantly associated with SMB including following a diet plan (OR 1.88 [95% CI 1.21-2.92]), keeping a diabetes journal (OR 3.83 [2.74-5.36]), holding a diabetes health passport (OR 6.11 [4.40-8.48]), SMBG (OR 2.96 [2.20-3.98]) and FSE (OR 2.64 [2.01-3.47]) as well as retinopathy screening (OR 3.30 [2.31-4.70]), HbA1c measurement (OR 2.58 [1.88-3.52]), and FEC (OR 3.68 [2.76-4.89]) after adjusting for confounders.
DSME-participation is associated with higher frequencies of various SMB and clinical care variables in routine care. Never-DSME attenders are more likely not to receive retinopathy screening, FEC and HbA1c measurements as recommended.
Clinicians should refer diabetes patients to a DSME and ensure a regular follow up for never-DSME attenders.
评估参与结构化糖尿病自我管理教育计划（DSME）与常规护理中自我管理行为（SMB）之间的关系。
本研究纳入了来自基于人群的德国健康更新调查（GEDA）2014/2015 年的 864 名曾参加过 DSME 组和 515 名从未参加过 DSME 组的参与者。SMB 和临床护理变量包括：遵循饮食计划、记录糖尿病日记、持有糖尿病健康护照、自我监测血糖（SMBG）、足部自我检查（FSE）、视网膜病变筛查、血红蛋白 A1c（HbA1c）测量和临床医生足部检查（FEC）。我们进行了逻辑回归分析，以调整各种变量后，DSME 参与与 SMB 的关联。
DSME 参与与 SMB 显著相关，包括遵循饮食计划（OR 1.88 [95%CI 1.21-2.92]）、记录糖尿病日记（OR 3.83 [2.74-5.36]）、持有糖尿病健康护照（OR 6.11 [4.40-8.48]）、SMBG（OR 2.96 [2.20-3.98]）和 FSE（OR 2.64 [2.01-3.47]）以及视网膜病变筛查（OR 3.30 [2.31-4.70]）、HbA1c 测量（OR 2.58 [1.88-3.52]）和 FEC（OR 3.68 [2.76-4.89]），调整混杂因素后。
DSME 参与与常规护理中各种 SMB 和临床护理变量的频率较高相关。从未参加过 DSME 的参与者更有可能未按建议接受视网膜病变筛查、FEC 和 HbA1c 测量。
临床医生应将糖尿病患者转介至 DSME，并确保定期随访从未参加过 DSME 的患者。
